Unfortunately, there is a strong bias towards raw basic science when it is given in the filed of medicine.Do you know ,there is no Nobel prize exclusive for medical science ? It shares with human physiology the only field included for Nobel prize in medicine.

Evolution of human history reveals it is not the stunning scientific discoveries that impact the mankind . It is largely dependent on how we use them . It is true and natural ,invention of sub atomic particles , decoding quantum mechanics and trans-cellular signals always generate great interest than others.

In medical science, time and again we have seen problems arise in applying fruits of scientific research into practical usage in the patient domain in the bedside.

What is use of rewarding inventor of nitric oxide with a Nobel prize , when billion-dollar nitrate industry is thriving on a non existing life long indication of stable angina .

It is surprising to note , Nobel committee does give credit to wisdom & intellect while awarding prize in peace, literary or economic sciences. For some reason it lacks such a vision when it comes to medical sciences !

We have seen Nobel prize being awarded to organization that strive for peace and welfare of society and community like UN ,EU etc.The world health organization is the premier power supposed to provide and regulate the health in this planet.I do not recall any time WHO was close to considered for the Noble prize in medicine !

Nobel Ironies

Nobel committee rewards economists who point out lacunae in vital world macro and micro economics theories.

Dubious men(Heads of state ) are decorated with Noble peace prizes for preventing a war in one geographical area while doing exactly the opposite elsewhere !

In this modern millennium where scientific pursuits are contaminated and many of the research questions are misdirected or irrelevant , Nobel committee needs a through rejig in the manner in which medical Nobel prize is being awarded. We know ,Noble’s death wish was to award the brightest mind with highest scientific breakthroughs in those world . . . but

I guess Alfred Nobel if alive would have changed his rules .He wouldn’t have imagined modern science would systematically devalue common sense and reinventing it would also deserve an award equivalent to Nobel !

Some of the medical discoveries that deserve noble medical prize

States which excel in school health nutrition and other basic health programs for the downtrodden

Doctors who promote bed side clinical skills

Tobacco eradication networks

Organisations like medicine san-frontiers which strives for basic life saving medication for all

Journal houses that specialise on Medical ethics and clinical sciences

Medical professionals and institutions provide value education

Medical economists who expose the wasted financial resources that widen the gap between sick and rich

How about Nobel prize in cardiology for preventive cardiologist who successfully terminates a million statin prescription and restoring natural exercise directed lipid regulation in them ?

How about Noble prize for a noble physician sitting in corporate hospital infested with all commercial ingredients who could resist and argue successfully against inappropriate tonsillectomies and appendectomies ?

I am sure , such a man will be a laughing stock for most of us !

An appeal to Nobel committee

It is a wish , Noble prize in medicine is to be included for people who do yeomen services in preventive and clinical care and professional who carry forward the legacy of caring for the sick with clinical application of available scientific wisdom !

In this scientifically obsessed world , It will be a new beginning in the way future medical research will be directed and nurtured ! Only then the true power of Noble prize in medicine will be realised !

In one of my meetings , I told a small gathering , that regular exercise can shrink atherosclerotic plaquesand regress CAD. I also quoted , a recent large study which has proven this fact convincingly !

I concluded, simple exercise and other life style changes,risk factor correction may convert a 90% lesion to 70 or even 50 % . I stressed the importance of this study and asked my colleagues to avoid misuse of Angioplasties .

When many seemed to agree with me , one angry Interventional cardiologist questioned me, and asked the name of the study, and in which journal it came , What was quality of the paper ?

I told him , It is an Imaginary studydone in my back yard . It never got published in print. You may call it as E-journal* , not exactly though.It is not available in any websites , but located in the biological servers, and neuronal circuits as digital imprints in learned brains !

*Journal of experience

You may call it , a scientific forgery , to quote a non-existent study,

“But this study benefits whole lot of my patients”.

He was amused , and became agitated !

He told over the mike , “You are making foolish statement. . . don’t corrupt young minds” !

May be , he is true !

I asked him to be calm and requested to listen to another study which I was about to quote . . .

He couldn’t sit any more and rushed out of the hall !

Final message

We are ready to believe all those rubbish stories about a fourth generation self disappearing BVS that is able to scaffold a coronary artery and maintain a MLD by 2.5mm and TVR by 20 % and prevent near MAZE at 30 days by 9 % and improve long term survival by 6 months at the cost of 100, 000 Rs per month .Only to realise, it may be a farce . . . 5 years down the lane !

How to cleanse the darkened face of science ?

When falsehoods come with evidence and harm people , Good deeds can be preached without evidence to save our fellow human beings !

One of the important principles of medicine is “Diagnosis should always precede treatment”

This quote , though appear reasonable , can not be practiced always especially in emergencies, where we have to first stabilise the patient without a prior diagnosis .(Like administering IV fluids in hypotension , acetaminophen for fever , etc)

Modern medicine considers treating a patient without a diagnosis as unscientific.

But, it is a well recognised fact , millions of decision in everyday medical practice is not based on scientific diagnosis but on clinical acumen and empirical therapy . There are many instances wherein , we are never near the diagnosis even after exhaustive investigations.

This happens because physicians always feel guilty if they are unable to label a patient with a disease entity.

Is the guilt justified ? Not necessarily so ! Symptomatic treatment without diagnosis is the most dominant theme even today (Fever, pain etc ).So don’t feel unduly negative* when one is not able to fit a patent’s symptom into a disease entity but ensure he gets relief from his symptom.